Primary Eyecare Center an Optometric Practice

Primary specialty

OptometristTaxonomy code 152W00000X

License

10330 Issued in CA

Legal business name

PRIMARY EYECARE CENTER AN OPTOMETRIC PRACTICE

Practice address

7605 Morro Rd
Atascadero, CA 93422-4433

Phone

(805) 466-3777

Fax

(805) 466-3700

NPI assigned

Dec 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Steven Sage Hider, O.D.NPI 1497739106

Title

Partner Optometrist

Phone

(805) 466-3777

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Primary Eyecare Center, an Optometric Practice

  • Optometrist
  • San Luis Obispo, CA
  • NPI 1013034537

  1456319979

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Primary Eyecare Center, an Optometric Practice

  • Optometrist
  • San Luis Obispo, CA
  • NPI 1013034537

  O20041229000869

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Primary Eyecare Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Primary Eyecare Center, an Optometric Practice

  • Optometrist
  • San Luis Obispo, CA
  • NPI 1013034537
  NPD tax ID

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Sage Hider, O.D.

  • Optometrist
  • Atascadero, CA
  • NPI 1497739106
  NPD Authorized official
• Amelene Gaoiran Bartlett, OD

  • Optometrist
  • Fresno, CA
  • NPI 1275213944
  NPD
• Quyen Tran Immoos, O.D.

  • Optometrist
  • Atascadero, CA
  • NPI 1215912449
  NPD
• Jocelyn Ou, OD

  • Optometrist
  • San Diego, CA
  • NPI 1225518996
  NPD
• Lauren Rebecca Tackett, O.D.

  • Optometrist
  • Atascadero, CA
  • NPI 1164618682
  NPD
• Valerie Mariko Suey, O.D.

  • Optometrist
  • San Antonio, TX
  • NPI 1366671075
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1164590766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7605 MORRO RD",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224433",
            "telephone_number": "805-466-3777",
            "fax_number": "805-466-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7605 MORRO RD",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224433",
            "telephone_number": "805-466-3777",
            "fax_number": "805-466-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY EYECARE CENTER AN OPTOMETRIC PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "HIDER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "SAGE",
        "authorized_official_title_or_position": "PARTNER OPTOMETRIST",
        "authorized_official_telephone_number": "805-466-3777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD000530-9",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD1699",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea C Prado
• Carleen Prado
• Bella Prestoza, M.D
• Elizabeth Dougherty Price, M.A. CCC-SLP
• Katherine E Price
• Michael Francis Pritchard, PHD
• Carrie Profitt, PHD, HSPP
• Gabriela Araceli Puga-Arevalo
• David Pyo, PH.D.
• Leticia Quezada

• Optometrist in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.